Department of Medicine, New York University School of Medicine, New York, NY 10016, USA.
Am J Bioeth. 2013;13(7):3-12. doi: 10.1080/15265161.2013.794876.
A significant number of asylum seekers who largely survived torture live in the United States. Asylum seekers have complex social and medical problems with significant barriers to health care access. When evaluating and providing care for survivors, health providers face important challenges regarding medical ethics and professional codes. We review ethical concerns in regard to accountability, the patient-physician relationship, and moral responsibilities to offer health care irrespective of patient legal status; competing professional responsibility toward society and the judiciary system; concerns about the consistency of asylum seekers' claims; ethical concerns surrounding involving trainees and researching within the evaluation setting; and the implication of broader societal views towards rights and social justice. We discuss contributing factors, including inadequate and insufficient provider training, varying and inadequate institutional commitment, asylum seekers' significant medical and social problems, and the broader health and social system issues. We review existing resources to address these concerns and offer suggestions.
相当数量的寻求庇护者在很大程度上幸存下来酷刑生活在美国。寻求庇护者有复杂的社会和医疗问题，获得医疗保健的障碍很大。在评估和为幸存者提供护理时，医疗服务提供者在医疗伦理和专业规范方面面临着重要的挑战。我们回顾了与问责制、医患关系以及向寻求庇护者提供医疗保健的道德责任有关的伦理问题，无论其法律地位如何；对社会和司法系统的竞争专业责任；对寻求庇护者主张的一致性的担忧；在评估环境中涉及培训生和研究的伦理问题；以及更广泛的社会对权利和社会正义的看法的影响。我们讨论了促成因素，包括提供者培训不足和不足、机构承诺的差异和不足、寻求庇护者的重大医疗和社会问题，以及更广泛的健康和社会系统问题。我们审查了现有的资源来解决这些问题，并提出了建议。
